Laparoscopic Transgastric Endoscopy after Roux-en-Y Gastric Bypass: Case Series and Review of the Literature

Richardson, Jason F.; Lee, John G.; Smith, Brian R.; Nguyen, Brian; Pham, Kathleen P; Nguyen, Ninh T.

doi:10.1177/000313481207801037

Cited by 47 publications

(18 citation statements)

References 37 publications

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“…We had one complication of post-ERCP necrotizing pancreatitis. Our failure and complication rates are consistent with those reported in the literature [ 4 , 5 , 10 ]. Limitations of our study include its retrospective nature and the small size of the case series.…”

Section: Discussionsupporting

confidence: 91%

Laparoscopic-Assisted Transgastric ERCP: A Single-Institution Experience

et al. 2018

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Background Laparoscopic-assisted transgastric endoscopic retrograde cholangiopancreatography (LAERCP) is used for treatment in patients after Roux-en-Y gastric bypass (RYGB), where transoral access to the biliary tree is not possible. We describe our technique and experience with this procedure. Methods Electronic medical record search was performed from September 2012 to January 2016, identifying patients who underwent LAERCP per operative records. Charts were reviewed for demographic, clinical, and outcomes data. Results Sixteen patients were identified. Average time since bypass was 6.9 years, and length of stay was 3.7 days. Five patients underwent simultaneous cholecystectomy. Eleven patients, or 43%, had cholecystectomy more than 2 years previously. ERCP with sphincterotomy was completed in 15 of 16 patients (94%). Our technique involves access to the bypassed stomach via a laparoscopically placed 15 mm port. We observed one major complication of post-ERCP necrotizing pancreatitis. No minor complications nor mortalities were seen in our series. Conclusion Biliary obstruction can occur many years after RYGB and cholecystectomy. Our findings suggest that RYGB patients may be at a higher risk of primary CBD stone formation. LAERCP is a reliable option for common bile duct (CBD) clearance; our technique of LAERCP is technically simple and associated with low complication rate, making it appealing to surgeons not trained in advanced laparoscopy.

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Section: Discussionsupporting

confidence: 91%

Laparoscopic-Assisted Transgastric ERCP: A Single-Institution Experience

et al. 2018

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“…The feasibility of LA-ERCP has been reported from a few single-center case series, with reported success rate ranging from 80% to 100% and adverse events rate ranging from 0% to 30% 6,7,[23][24][25][27][28][29][30][31][32] . These reports are limited by small sample size and heterogeneous definitions of procedure success and adverse events.…”

Section: Discussionmentioning

confidence: 99%

Multicenter evaluation of the clinical utility of laparoscopy-assisted ERCP in patients with Roux-en-Y gastric bypass

Abbas¹,

Strong²,

Diehl³

et al. 2018

Gastrointestinal Endoscopy

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“…A 2012 review of LA-ERCP found a papillary cannulation rate of 99%, and a complication rate of 7.2%. 35…”

Section: Surgerymentioning

confidence: 99%

Choledocholithiasis: Evaluation, Treatment, and Outcomes

Molvar

Glaenzer

2016

Semin intervent Radiol

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Choledocholithiasis occurs in up to approximately 20% of patients with cholelithiasis. A majority of stones form in the gallbladder and then pass into the common bile duct, where they generate symptoms, due to biliary obstruction. Confirmatory diagnosis of choledocholithiasis is made with advanced imaging, including magnetic resonance cholangiopancreatography and endoscopic retrograde cholangiopancreatography (ERCP). Treatment varies locally; however, ERCP with sphincterotomy is most commonly employed with a high degree of success. Difficult anatomy and difficult stone burden require advanced surgical, endoscopic, and percutaneous techniques to extract or expel biliary stones. Knowledge of these treatment strategies will optimize outcomes.

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Laparoscopic Transgastric Endoscopy after Roux-en-Y Gastric Bypass: Case Series and Review of the Literature

Cited by 47 publications

References 37 publications

Laparoscopic-Assisted Transgastric ERCP: A Single-Institution Experience

Laparoscopic-Assisted Transgastric ERCP: A Single-Institution Experience

Multicenter evaluation of the clinical utility of laparoscopy-assisted ERCP in patients with Roux-en-Y gastric bypass

Choledocholithiasis: Evaluation, Treatment, and Outcomes

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